Endoscope with integrated stabilizer and cannula element

Abstract

An endoscope system can include an arm and a scope body defining a working channel extending along a longitudinal axis of the scope body. The working channel can define an opening of the working channel at a distal tip of the scope body. The arm can be connected to the distal tip of the scope body and can be movable relative to the scope body and the working channel to engage and clear tissue from the opening of the working channel.

Description

Priority requirements

[0001] This patent application claims priority to U.S. Patent Application Serial No. 63 / 557,865, filed February 26, 2024, entitled “ENDOSCOPEWITH INTEGRATED STABILIZER AND CANNULATION ELEMENTS”, which is incorporated herein by reference in its entirety. Technical Field

[0002] This disclosure generally relates to medical devices and instruments configured to provide diagnostic and therapeutic procedures. More specifically, this disclosure relates to medical device systems, such as endoscopes, comprising elongated bodies, which can be inserted into incisions or openings in a patient's anatomical structures and advanced to locations deep within the patient's anatomical passages to perform diagnostic and therapeutic procedures thereon. Background Technology

[0003] Endoscopes can be used to provide access to various anatomical sites for other devices (such as treatment devices or tissue collection devices), or to image such anatomical sites. Such anatomical sites may include the gastrointestinal tract (e.g., esophagus, stomach, duodenum, pancreaticobiliary duct, intestine, colon, etc.), the renal region (e.g., kidneys, ureter, bladder, urethra), and other internal organs (e.g., reproductive system, sinus cavities, submucosal regions, respiratory tract). Summary of the Invention

[0004] In endoscopy, the distal portion of the endoscope can be configured to support and orient the treatment device. Currently, some ureteroscopes have distal portions that allow irrigation of the surgical area via a working channel during lithotripsy. Kidney stone fragments generated during the procedure can be removed using a stone retrieval basket, and dust (such as smaller fragments) can remain in the kidney and be expelled naturally during urination. Next-generation ureteroscopes may have separate channels to enable saline irrigation and aspiration of stone dust. Aspiration of stone dust can be achieved via the working channel. One problem that arises during aspiration is that fragments can become lodged or impaled at the opening of the distal tip of the endoscope in the working channel, which may restrict or prevent further aspiration of fluid and dust. This can delay the procedure and cause user dissatisfaction.

[0005] This disclosure can help address these issues by including a clearance device connected to the distal end of the endoscope. When the working channel is blocked or jammed by stone fragments, the clearance device can be operated (manually or automatically) to remove the stone fragments from the working channel, allowing the procedure to continue, helping to save time and reduce patient complications.

[0006] For example, an endoscopic system may include an arm and a body defining a working channel extending along the longitudinal axis of the body. The working channel defines an opening at the distal tip of the body. The arm may be attached to the distal tip of the body and is movable relative to the body and the working channel to engage and remove tissue from the opening of the working channel.

[0007] The foregoing discussion is intended to provide an overview of the subject matter of this patent application. It is not intended to provide an exclusive or exhaustive description of the invention. The following description is included to provide additional information regarding this patent application. Attached Figure Description

[0008] In drawings that are not necessarily drawn to scale, similar reference numerals can describe similar parts in different views. Similar reference numerals with different letter suffixes can indicate different instances of similar parts. The drawings generally illustrate the various embodiments discussed in this document by way of example rather than limitation.

[0009] Figure 1 A schematic diagram of an endoscope system is shown.

[0010] Figure 2 yes Figure 1 A schematic diagram of the imaging and control system, which shows the imaging and control system connected to the endoscope.

[0011] Figure 3 A schematic diagram of the distal portion of the endoscope and the control system is shown.

[0012] Figure 4 A side view of a portion of the endoscope in its first state is shown.

[0013] Figure 5 A side view of a portion of the endoscope in a second state is shown.

[0014] Figure 6 This shows an end view of a portion of the endoscope in a second state.

[0015] Figure 7A This shows a portion of the endoscope in its first state.

[0016] Figure 7B This shows an end view of a portion of the endoscope in a second state.

[0017] Figure 8A A side cross-sectional view of a portion of the endoscope is shown.

[0018] Figure 8B A side cross-sectional view of a portion of the endoscope is shown.

[0019] Figure 8CA side cross-sectional view of a portion of the endoscope is shown.

[0020] Figure 8D A side cross-sectional view of a portion of the endoscope is shown.

[0021] Figure 9A This shows a portion of the endoscope in its first state.

[0022] Figure 9B This shows an end view of a portion of the endoscope in a second state.

[0023] Figure 10 A side cross-sectional view of a portion of the endoscope is shown.

[0024] Figure 11 A schematic diagram of a portion of an endoscope is shown.

[0025] Figure 12 A block diagram showing an example of a machine on which one or more implementations can be carried out. Detailed Implementation

[0026] Figure 1 This is a schematic diagram of an endoscope system 10 that may include an imaging and control system 12 and an endoscope 14. Figure 1 The system described herein is an illustrative example of an endoscope system applicable to the systems, apparatus and methods described herein, such as an endoscope having an integrated guide and arm for guiding the extension of an auxiliary endoscope body.

[0027] Endoscope 14 may be inserted into an anatomical region for imaging, or to provide access to one or more sampling devices for biopsy or one or more treatment devices for treating a disease condition associated with the anatomical region, or to be attached (e.g., via tethering) to said one or more sampling devices or said one or more treatment devices. Endoscope 14 may interface with and be connected to imaging and control system 12. Endoscope 14 may also include a ureteroscope, but other types of endoscopes may be used in conjunction with the features and teachings of this disclosure. Imaging and control system 12 may include control unit 16, output unit 18, input unit 20, light source unit 22, fluid source 24, and suction pump 26.

[0028] The imaging and control system 12 may include various ports for coupling with the endoscope system 10. For example, the control unit 16 may include a data input / output port for receiving data from and transmitting data to the endoscope 14. The light source 22 may include an output port for transmitting light, for example, via an optical fiber link, to the endoscope 14. The fluid source 24 may include a port for transmitting fluid to the endoscope 14. The fluid source 24 may include, for example, a pump and tank of fluid, or may be connected to an external tank, container, or storage unit. The suction pump 26 may include a port for creating a vacuum from the endoscope 14 to generate suction, such as for withdrawing fluid from an anatomical region into which the endoscope 14 is inserted. The output unit 18 and the input unit 20 may be used by the operator of the endoscope system 10 to control the functions of the endoscope system 10 and to view the output of the endoscope 14. The control unit 16 may also be used to generate signals or other outputs by treating the anatomical region into which the endoscope 14 is inserted. In some examples, the control unit 16 can generate electrical output, acoustic output, fluid output, etc., for use in treating anatomical areas using methods such as cauterization, cutting, freezing, etc.

[0029] The endoscope 14 may include an insertion section 28, a functional section 30, and a handle section 32, which may be coupled to a cable section 34 and a coupler section 36. The coupler section 36 may be connected to a control unit 16 to connect the endoscope 14 to various features of the control unit 16, such as an input unit 20, a light source unit 22, a fluid source 24, and a suction pump 26.

[0030] Insertion segment 28 extends distally from handle segment 32, and cable segment 34 extends proximally from handle segment 32. Insertion segment 28 may be elongated and includes a curved segment and a distal end to which functional segment 30 may be attached. The curved segment may be controllable (e.g., via a control knob 38 on handle segment 32) to manipulate the distal end through tortuous anatomical pathways (e.g., stomach, duodenum, kidney, ureter, etc.). Insertion segment 28 may also include one or more working channels (e.g., lumens), which may be elongated and support one or more therapeutic instruments of functional segment 30, such as ( Figure 4 The auxiliary mirror 134 is inserted. The working channel can extend between the handle section 32 and the functional section 30. Additional functions such as fluid passage, guide wire, and pull wire can also be provided by the insertion section 28 (e.g., via a suction or flushing channel).

[0031] The handle section 32 may include a control knob 38 and a port 40a. The control knob 38 may be connected to a pull cable or other actuating mechanism extending through the insertion section 28. The port 40a and other mechanisms may include (…). Figure 2 Other ports of port 40B can be configured to couple various cables, guide wires, auxiliary mirrors, tissue collection devices, fluid tubes, etc. of this disclosure to handle section 32, for example, for coupling with insertion section 28.

[0032] Imaging and control system 12 can be mounted on a mobile platform (e.g., a trolley 41) having a means of housing a light source 22, a suction pump 26, and an image processing unit 42. Figure 2 Shelves, etc. Alternative locations, such as... Figure 1 and Figure 2 Several components of the imaging and control system 12 shown can be directly mounted on the endoscope 14 so that the endoscope is self-contained.

[0033] Functional section 30 may include components for treating and diagnosing a patient's anatomy. Functional section 30 may include imaging devices, illumination devices, and guides, as further detailed below. Functional section 30 may also include optically enhanced biomaterial and tissue retrieval devices as described herein. For example, functional section 30 may include one or more electrodes electrically connected to handle section 32 and functionally connected to imaging and control system 12 to analyze biomaterial in contact with the electrodes based on contrast biological data stored in imaging and control system 12.

[0034] Figure 2 yes Figure 1 A schematic diagram of an endoscope system 10, which includes an imaging and control system 12 and an endoscope 14. Figure 2Components of an imaging and control system 12 coupled to an endoscope 14, which in the illustrated example includes a ureteroscope, are schematically shown. The imaging and control system 12 may include a control unit 16, which may include or be coupled to an image processing unit 42, a treatment generator 44, a drive unit 46, a light source 22, an input unit 20, and an output unit 18. The control unit 16 may include, or be in communication with, the endoscope 100, surgical instruments, and the endoscopic system. It may include means configured to engage tissue and collect and store a portion of that tissue, and an imaging device (e.g., a camera device) may be used to view the target tissue via the means including optically enhanced materials and components. The control unit 16 may be configured to activate the camera device to view the target tissue distal to the surgical instruments and the endoscopic system. Similarly, the control unit 16 can be configured to enable the light source unit 22 to illuminate a surgical instrument, which may include selected components configured to reflect light in a particular manner, such as a tissue cutter enhanced with reflective particles.

[0035] Image processing unit 42 and light source 22 can each interface with endoscope 14 via wired or wireless connection (e.g., at functional section 30). Therefore, imaging and control system 12 can illuminate the anatomical region, collect signals representing the anatomical region, process signals representing the anatomical region, and display images representing the anatomical region on display unit 18. Imaging and control system 12 may include light source 22 to illuminate the anatomical region using light of a desired spectrum (e.g., broadband white light, narrowband imaging using preferred electromagnetic wavelengths, etc.). Imaging and control system 12 can be connected to endoscope 14 (e.g., via endoscope connector) for signal transmission (e.g., light output from the light source, video signals from the distal imaging system, diagnostic and sensor signals from diagnostic equipment, etc.).

[0036] Fluid source 24 ( Figure 1 The endoscope 14 (shown in the diagram) can communicate with control unit 16 and may include one or more air sources, saline sources, or other fluid sources, as well as associated fluid paths (e.g., air passages, flushing passages, suction passages, etc.) and connectors (barbed fittings, fluid seals, valves, etc.). Fluid source 24 can be used as enabling energy for biasing or pressure application devices used in this disclosure. Imaging and control system 12 may also include a drive unit 46, which may include a motorized actuator for advancing the distal segment of endoscope 14.

[0037] Coupler section 36 can be connected to control unit 16 to connect endoscope 14 to various features of control unit 16, such as image processing unit 42 and treatment generator 44. In an example, port 40a can be used to insert another instrument or device (e.g., a daughter scope or auxiliary scope) into endoscope 14. Such instruments and devices can be independently connected to control unit 16 via cable 47. In some examples, port 40B can be used to connect coupler section 36 to various inputs and outputs, such as video, air, light, and electricity.

[0038] Figure 3 This is a schematic diagram of the distal portion of an endoscope 100, which may be part of an endoscope system 10, such as endoscope 14. The endoscope 100 may include a distal portion 102 and a control module 104. The control module 104 may include a controller 106. The control module 104 may include other components, such as those shown in the reference diagram. Figure 1 Endoscopic system 10 and Figure 2 The control unit 16 describes the components mentioned above. Additionally, the control module 104 may include components for controlling the imaging device and light source connected to the auxiliary mirror (or sub-mirror), such as the imaging unit 108, illumination device 110, and power supply unit 112. The endoscope 100 can be as follows: Figure 1 and Figure 2 The endoscope 14 is similarly configured. The control module 104 may also include an actuator 114 (e.g., a motor, etc.) for operating the arm of the endoscope 100 (described in further detail below).

[0039] Endoscope 100 may also include a working channel 116, which includes a distal opening 118. The working channel 116 may be an orifice, passageway, channel, lumen, etc., extending through endoscope 100, for example, through insertion segment 28. The working channel 116 may be configured to support or pass through one or more instruments therein, and may be configured to receive fluid flow, such as suction pressure, through it during removal of stone fragments or dust. Endoscope 100 may also include an irrigation channel 120, which may be an orifice, passageway, channel, lumen, etc., extending through endoscope 100, for example, through insertion segment 28. The irrigation channel 120 may be configured to receive fluid and drain fluid into a body cavity (such as the ureter) during procedures such as lithotripsy. The irrigation channel 120 may be isolated from the working channel 116, but the irrigation channel 120 may be connected to the working channel 116, as further detailed below.

[0040] Endoscope 100 may also include sensor 122. Sensor 122 may be one of several types of sensors, such as pressure sensors, temperature sensors, optical sensors, etc. For example, sensor 122 may be an image capture sensor and may include a lens, an image capture sensor, and a chip or processor. Optionally, one or more of these components may be located in or connected to image processing unit 42. Sensor 122 may be connected to an external portion of endoscope 100 or a distal end face of endoscope 100. Optionally, sensor 122 may be angled relative to the outer surface of endoscope 100 or relative to the longitudinal axis of endoscope 100.

[0041] The endoscope 100 may also include an arm 124 connected to the distal portion 102 of the endoscope 100. The arm 124 may be an arm-like member, rod, blade-like member, armature, etc., movable relative to the endoscope body and working channel 116 to engage and remove tissue from the opening 118 of the working channel 116. Optionally, the arm 124 may communicate with a control module 104. The control module 104 may control the operation of the arm 124, for example, to remove stone fragments or tissue when the distal opening 118 is determined to be blocked. For example, the arm 124 may be connected to an actuator 114 such that the control module 104 can operate the actuator 114 to move the arm 124 relative to the distal portion 102 and the working channel 116. Optionally, one or more components of the control module 104 may be connected to a handle section 32 such that a user can operate one or more components of the control module 104 using the handle section 32. For example, a user can control the arm 124 by operating the actuator 114 via the endoscope handle.

[0042] In some example operations, sensor 122 may be configured to transmit a signal to control module 104 (e.g., to controller 106). Control module 104 may be configured to determine or detect, based on the signal, whether there is a blockage in the distal opening 118 of the working channel 116. When controller 106 determines or detects a blockage, controller 106 may operate actuator 114 to move arm 124 to clear the blockage, as further detailed below.

[0043] Figure 4 A side view of a portion of the endoscope 100 in a first state is shown. Figure 5 A side view of a portion of the endoscope 100 in a second state is shown. Figure 6 An end view of a portion of the endoscope 100 in a second state is shown. Figures 4 to 6 They will be discussed together below. Endoscope 100 may be consistent with the endoscope 100 discussed above. Figures 4 to 6 Additional details of the endoscope 100 are shown. For example, Figures 4 to 6 This illustrates how the endoscope 100 operates to remove stones or tissue 50.

[0044] Figures 4 to 6 The endoscope 100 is also shown to include a wire or shaft 126 that extends at least partially through an actuator cavity 128 of the endoscope body to connect an actuator 114 to an arm 124. The shaft 126 and the actuator cavity 128 (as well as the working channel 116 and the flushing channel 120) may extend along a longitudinal axis A of the endoscope 100. The actuator cavity 128 may be separable from or isolated from the working channel 116. The arm 124 may be at least partially located within the actuator cavity 128 and may be movable along the actuator cavity 128. The shaft 126 may be rigid or semi-rigid and is made of one or more of foam, metal, polymer, etc. The shaft may be operated by the actuator 114 to push, pull, rotate, pivot, or otherwise move the arm 124 relative to the actuator cavity 128, the working channel 116, and the distal opening 118.

[0045] Figures 4 to 6 The diagram also illustrates how the endoscope 100 is operated to clear the working channel 116. For example, as... Figure 4 As shown, during normal operation of the endoscope 100 (e.g., aspiration or extraction of stone dust or fragments through the working channel 116), the arm 124 can be in a retracted state or condition within the actuator cavity 128. When the distal opening 118 is blocked by stone fragments or tissue 50, such as Figure 5 As shown, control module 104 (e.g., when a blockage is detected) can operate actuator 114 to move axis 126, thereby moving arm 124. During such operation, arm 124 can move from proximal to distal to engage tissue 50 and push tissue 50 out of distal opening 118 and working channel 116, as... Figure 5 As shown, the distal opening 118 is cleaned so that suction can return to normal.

[0046] like Figure 5 and Figure 6 As shown, when arm 124 moves distally, arm 124 can move upward (from...). Figure 5 and Figure 6 The arm 124 can move inwards (either in the direction of view) or laterally (e.g., toward the center of the endoscope 100 or toward the opposite side of the endoscope 100). Such movement can be guided by the actuator cavity 128 (which may optionally be bent or shaped to allow the arm 124 to move in such a direction). The movement can also be caused at least partially by the shape of the arm 124. For example, the arm 124 may be bent or flexed to bias the movement of the arm 124. Optionally, the arm 124 may be made of an elastic material, such as spring steel (or a similar alloy), which is configured to bend once the arm 124 extends at least partially beyond the actuator cavity 128 and is free to bend or flex. Figure 6It is also shown that arm 124 is movable over the entire distal opening 118, which can help ensure that arm 124 is able to remove stones of any size from the distal opening 118. Although arm 124 is shown to have a width smaller than the diameter of working channel 116, the width of arm 124 may be equal to the diameter of working channel 116.

[0047] Figure 7A A partial end view of the endoscope 700 in its first state is shown. Figure 7B An end view of a portion of the endoscope 700 in a second state is shown. Figures 7A to 7B This will be discussed together below. Endoscope 700 may be similar to endoscope 100 discussed above. For example, endoscope 700 may be part of endoscope 14 or endoscope system 10. Endoscope 700 may include a distal portion 702, which includes a working channel 716 having a distal opening 718. Endoscope 700 may also include a flushing channel 720 and an actuator cavity. Endoscope 700 may also include an arm 724 that can be connected to shaft 726.

[0048] Arm 724 can be a rigid or semi-rigid arm, blade, rod, armature, etc., configured to rotate about the distal end face 730 of the distal portion 702, for example, to engage tissue. Arm 724 can be curved, complementary in shape to the distal opening 718 (or working channel 716), such that when arm 724 is in a first state (e.g.) Figure 7A As shown), arm 724 avoids distal opening 718, thereby limiting obstruction to working channel 716 during suction or other (e.g., lithotripsy) operations. In other examples, arm 724 may be straight or have other shapes. Shaft 726 may be connected to arm 724 and to an actuator (e.g., actuator 114) such that the actuator can rotate arm 724 about shaft 726 to move arm 724 from a first state to a second state (e.g., as shown). Figure 7B (As shown). Arm 724 can be configured to rotate between 5 degrees and 360 degrees or greater. In some examples, actuator 114 can be operable to rotate the arm such that arm 724 does not extend beyond the width of endoscope 100.

[0049] In some example operations, a sensor (e.g., sensor 122) may be configured to transmit a signal to a control module 104 (e.g., to a controller 106). The control module 104 may be configured to determine or detect, based on this signal, whether there is a blockage in the distal opening 718 of the working channel 716. When the controller 106 determines or detects a blockage, the controller 106 may operate an actuator 114 to move an arm 724 to clear any blockage or tissue stuck in the working channel 716 or the distal opening 718. In some examples, the arm 724 may have one or more sharp edges, serrations, or other contours or shapes to facilitate the removal of tissue from the distal opening 718. The arm 724 may also be configured to engage tissue using both sides of the arm 724 (e.g., in both rotational directions of the arm 724).

[0050] Figure 8A A side cross-sectional view of a portion of the endoscope 800A is shown. Figure 8B A side cross-sectional view of a portion of the endoscope 800B is shown. Figure 8C A side cross-sectional view of a portion of the endoscope 800C is shown. Figure 8D A side cross-sectional view of a portion of the 800D endoscope is shown. Figures 8A to 8D They will be discussed together below. Endoscopes 800A to 800D (Endoscope 800) can be similar to the Endoscope 700 discussed above. Figures 8A to 8D Different arrangements of arm 824 are shown. Each endoscope in endoscope 800 may include a distal portion 802, a working channel 816 (having a distal opening 818), a flushing channel 820, and an actuator cavity 818. Shaft 826 may extend at least partially through face 830 to connect to arm 824 which may be located at or near distal opening 818.

[0051] The arm 824 of endoscope 800A can be offset distally relative to the surface 830 of the distal portion 802. The arm 824 of endoscope 800B can be located distal to the surface 830 of the distal portion 802, or can be close to the surface 830 or offset distally relative to the surface 830. The arm 824 of endoscope 800C can be offset proximally relative to the surface 830 of the distal portion 802. The arm 824 of endoscope 800D can be located proximally to the surface 830 of the distal portion 802, or can be close to the surface 830 or offset proximally relative to the surface 830.

[0052] Figure 9A A partial end view of the endoscope 900 in its first state is shown. Figure 9B A partial end view of the endoscope 900 in a second state is shown. Figures 9A to 9BThis will be discussed together below. Endoscope 900 may be similar to the endoscopes discussed above; endoscope 900 may include a pivoting arm. Any endoscope discussed above or below may include the features of endoscope 900.

[0053] Endoscope 900 may include a distal portion 902, a working channel 916 (having a distal opening 918), and a flushing channel 920. A portion of an actuator or shaft 926 may extend at least partially through a face 930 of the distal portion 902 to connect to an arm 924 that may be located at or near the distal opening 918. The arm may be relatively flat or planar and may be configured such that when the arm 924 is in a first state (e.g., ... Figure 9A (As shown) mates with surface 930 and can be configured to extend (e.g., pivot or rotate) away from surface 930 (as shown) Figure 9B (As shown). Arm 924 may include an opening 932 that extends at least partially through arm 924 and may be configured to align with a distal opening 918. The size of opening 932 may be the same as, or slightly larger than, the distal opening 918. For example, if the size of opening 932 is the same as or smaller than the distal opening 918, tissue or debris may be pre- or partially pre-entered in arm 924 before being trapped in the distal opening 918, which may facilitate the clearing of the distal opening 918. Alternatively, opening 932 may be larger than the distal opening 918, for example, to limit obstruction of, for example, flow into working channel 916.

[0054] In some example operations, a sensor (e.g., sensor 122) may be configured to transmit a signal to a control module 104 (e.g., to a controller 106). The control module 104 may be configured to determine or detect, based on this signal, whether there is a blockage in the distal opening 918 of the working channel 916. When the controller 106 determines or detects a blockage, the controller 106 may operate an actuator 114 to pivot or rotate an arm 924 (e.g., using a shaft 926) to clear any blockage or tissue stuck in the working channel 916, the distal opening 918, or the opening 932.

[0055] Figure 10 A side cross-sectional view of a portion of endoscope 1000 is shown. Endoscope 1000 may be similar to the endoscopes discussed above; endoscope 1000 may include a fluid clearance mechanism. Any endoscope discussed above or below may include the features of endoscope 1000.

[0056] Endoscope 1000 may include a distal portion 1002, a working channel 1016 (having a distal opening 1018), and a flushing channel 1020. Endoscope 1000 may also include a bypass channel 1034 connecting the flushing channel 1020 to the working channel 1016, and may include a valve 1036 at least partially located within the bypass channel 1034 or between the flushing channel 1020 and the working channel 1016. Valve 1036 may be a shut-off valve, such as a ball valve, butterfly valve, gate valve, solenoid valve, diaphragm valve, etc. Valve 1036 may be manually (e.g., by a user) operated, for example, via a remote button or lever (e.g., located on handle portion 32), or valve 1036 may include an actuator that can be connected to a control module 104 (e.g., connected to controller 106).

[0057] The flushing channel 1020 can be connected to a fluid source 24, such as a fluid pump, so that the fluid pump is operable to generate a fluid flow through the flushing channel 1020. Similarly, a vacuum pump 26 can be in fluid communication with the working channel 1016, and the vacuum pump 26 can be operable to generate a vacuum flow through the working channel 1016 to aspirate or extract debris (e.g., stone dust or fragments) from the body cavity.

[0058] In some example operations, a sensor (e.g., sensor 122) may be configured to transmit a signal to a control module 104 (e.g., to a controller 106). The control module 104 may be configured to determine or detect, based on this signal, whether the distal opening 1018 of the working channel 1016 is blocked. When the controller 106 determines or detects a blockage, it may disable the suction flow through the working channel 1016, for example, by disabling the suction pump 26. The controller 106 may then operate a valve 1036 to divert fluid flow from the flushing channel 1020 to the working channel 1016 to engage tissue located at or near the opening 1018, thereby clearing tissue or stone portions, for example, from the distal opening 1018. Once it is determined that the distal opening 1018 is cleared (e.g., using sensor 122 and controller 106), the valve 1036 may be operated to close, preventing fluid from flowing from the flushing channel 1020 into the working channel 1016. The suction pump 26 may then be activated to resume normal operation.

[0059] Figure 11 A schematic diagram of valve 1036 in 1034 is shown. Figure 11The valve 1036 is shown to include a body 1038 and a movable portion 1040 movable relative to the body 1038. The valve 1036 may also include an opening 1042 extending at least partially through one or more movable portions 1040 and the body 1038. The movable portion 1040 may be connected to the actuator 114, for example, via a cable or shaft 1026. This allows the controller 106 to operate the valve 1036 to open, thereby allowing fluid to flow through a bypass passage 1034. The valve 1036 may optionally be normally closed, such that when the controller 106 does not send a signal to operate the actuator, the movable portion 1040 can be biased to close the opening 1042, thereby preventing or restricting flow through the bypass passage 1034 and the valve 1036.

[0060] Figure 12 A block diagram of an exemplary machine 1200 is shown, on which any or more of the techniques (e.g., methods) discussed herein can be performed. Examples as described herein may include, or be operated by, logic or components or mechanisms in machine 1200. A circuit (e.g., processing circuitry) is a collection of circuits implemented in a tangible entity of machine 1200 that includes hardware (e.g., simple circuits, gates, logic, etc.). Circuit system members can be flexible over time. A circuit system includes components that can perform specified operations individually or in combination during operation. In the example, the hardware of the circuit system may be immutably designed to perform a specific operation (e.g., hardwired). In the example, the hardware of the circuit may include physical components (e.g., execution units, transistors, simple circuits, etc.) connected in a variable manner, including machine-readable media that are physically modified (e.g., magnetic ground, electrical ground, movable placement of immutable aggregate particles, etc.) to encode instructions for a specific operation. When connecting physical components, the underlying electrical characteristics of the hardware components change, for example, from insulator to conductor, and vice versa. Instructions enable embedded hardware (e.g., an execution unit or loading mechanism) to create components of a circuit in the hardware via variable connections to perform specific operations during operation. Thus, in the example, a machine-readable medium element is part of a circuit system, or communicatively connected to other components of the circuit system during device operation. In the example, any physical component can be used in more than one component of more than one circuit system. For example, during operation, an execution unit can be used in a first circuit of a first circuit system at one point in time, and reused at different times by a second circuit of the first circuit system or by a third circuit of the second circuit system. Additional examples of these components of machine 1200 are as follows.

[0061] In alternative implementations, machine 1200 may operate as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, machine 1200 may operate as a server machine, a client machine, or both in a server-client network environment. In the example, machine 1200 may act as a peer-to-peer (P2P) (or other distributed) network environment. Machine 1200 may be a personal computer (PC), tablet PC, set-top box (STB), personal digital assistant (PDA), mobile phone, web appliance, network router, switch, or bridge, or any machine capable of (sequentially or otherwise) executing instructions specifying actions to be taken by that machine. Furthermore, although only a single machine is shown, the term "machine" should also be understood to include any collection of machines that individually or jointly execute a set (or more) of instructions to perform any or more of the methods discussed herein, such as cloud computing, Software as a Service (SaaS), or other computer cluster configurations.

[0062] Machine (e.g., computer system) 1200 may include hardware processor 1202 (e.g., central processing unit (CPU), graphics processing unit (GPU), hardware processor core, or any combination thereof), main memory 1204, static memory (e.g., memory or storage device for firmware, microcode, basic input / output (BIOS), unified extensible firmware interface (UEFI), etc.) 1206, and mass storage device 1208 (e.g., hard disk drive, tape drive, flash memory, or other block device), some or all of which may communicate with each other via interconnect link (e.g., bus) 1230. Machine 1200 may also include display unit 1210, alphanumeric input device 1212 (e.g., keyboard), and user interface (UI) navigation device 1214 (e.g., mouse). In this example, display unit 1210, input device 1212, and UI navigation device 1214 may be a touchscreen display. Machine 1200 may additionally include a storage device (e.g., a drive unit) 1208, a signal generation device 1218 (e.g., a speaker), a network interface device 1220, and one or more sensors 1216, such as a Global Positioning System (GPS) sensor, a compass, an accelerometer, or other sensors. Machine 1200 may include an output controller 1228, such as a serial (e.g., Universal Serial Bus (USB)), parallel, or other wired or wireless (e.g., infrared (IR), near field communication (NFC), etc.) connection, to communicate with or control one or more peripheral devices (e.g., a printer, a card reader, etc.).

[0063] The registers of processor 1202, main memory 1204, static memory 1206, or mass storage device 1208 may be or include machine-readable medium 1222 on which one or more sets of data structures or instructions 1224 (e.g., software) are stored, said set of one or more sets of data structures or instructions 1224 embodying or being utilized by any one or more of the techniques or functions described herein. During execution of instructions 1224 by machine 1200, instructions 1224 may also reside wholly or at least partially in any register of processor 1202, main memory 1204, static memory 1206, or mass storage device 1208. In this example, one or any combination of hardware processor 1202, main memory 1204, static memory 1206, or mass storage device 1208 may constitute machine-readable medium 1222. Although machine-readable medium 1222 is shown as a single medium, the term "machine-readable medium" can include a single medium or multiple media (e.g., a centralized or distributed database, and / or associated caches and servers) configured to store one or more instructions 1224.

[0064] The term "machine-readable medium" can include any medium capable of storing, encoding, or carrying instructions for execution by machine 1200 and causing machine 1200 to perform any one or more of the technologies of this disclosure, or capable of storing, encoding, or carrying data structures used by or associated with such instructions. Examples of non-limiting machine-readable media can include solid-state memory, optical media, magnetic media, and signals (e.g., radio frequency signals, other photon-based signals, sound signals, etc.). In examples, non-transitory machine-readable media includes machine-readable media having multiple particles with invariant (e.g., rest) masses and thus being a component of matter. Therefore, a non-transitory machine-readable medium is a machine-readable medium that does not include transiently propagating signals. Specific examples of non-transitory machine-readable media can include: non-volatile memory, such as semiconductor memory devices (e.g., electrically programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM)) and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks.

[0065] Commands 1224 can also be sent or received via the communication network 1226 using a transmission medium via the network interface device 1220, utilizing any of several transport protocols (e.g., Frame Relay, Internet Protocol (IP), Transmission Control Protocol (TCP), User Datagram Protocol (UDP), Hypertext Transfer Protocol (HTTP), etc.). Example communication networks may include local area networks (LANs), wide area networks (WANs), packet data networks (e.g., the Internet), mobile phone networks (e.g., cellular networks), conventional telephone (POTS) networks, and wireless data networks (e.g., the IEEE 802.11 family of standards known as Wi-Fi®, the IEEE 802.16 family of standards known as WiMax®), the IEEE 802.15.4 family of standards, peer-to-peer (P2P) networks, etc. In the example, the network interface device 1220 may include one or more physical jacks (e.g., Ethernet, coaxial, or telephone jacks) or one or more antennas for connection to the communication network 1226. In the example, network interface device 1220 may include multiple antennas to perform wireless communication using at least one of single-input multiple-output (SIMO), multiple-input multiple-output (MIMO), or multiple-input single-output (MISO) technologies. The term "transmission medium" should be considered to include any intangible medium capable of storing, encoding, or carrying instructions for execution by machine 1200, and includes digital or analog communication signals or other intangible media to facilitate communication of such software. The transmission medium is a machine-readable medium. Annotations and Examples

[0066] The following non-limiting examples illustrate certain aspects of this topic to address challenges and provide the benefits discussed herein.

[0067] Example 1 is an endoscope system comprising: an endoscope body defining a working channel extending along a longitudinal axis of the endoscope body, the working channel defining an opening at a distal tip of the endoscope body; and an arm connected to the distal tip of the endoscope body and movable relative to the endoscope body and the working channel to engage from the opening of the working channel and remove tissue.

[0068] In Example 2, the subject of Example 1 may optionally include an actuator connected to the arm and operable to move the arm relative to the mirror body and the working channel.

[0069] In Example 3, the subject of Example 2 may optionally include a lens handle connected to the proximal portion of the lens body, an actuator connected to the lens handle, and the actuator being operable by the user via the lens handle.

[0070] In Example 4, any one or more of the subjects in Examples 2 to 3 may optionally include a controller connected to the mirror body and configured to transmit signals to the actuator to operate the actuator.

[0071] In Example 5, the subject of Example 4 may optionally include a sensor configured to transmit a signal to a controller configured to detect a blockage at the distal tip based on the signal, and the controller configured to operate an actuator when a blockage is detected.

[0072] In Example 6, the subject of any or more of Examples 2 to 5 may optionally include a line or axis that extends at least partially through the mirror body to connect the actuator to the arm.

[0073] In Example 7, the subject matter of Example 6 may optionally include an actuator cavity extending along the longitudinal axis of the mirror body and separated from the working channel, wherein an arm, line, or shaft is at least partially located within the actuator cavity and is movable along the actuator cavity.

[0074] In Example 8, the subject matter of any one or more of Examples 6 to 7 may optionally include an actuator cavity extending along the longitudinal axis of the scope and separated from the working channel, wherein an arm or wire or shaft is at least partially located within the actuator cavity and movable from the actuator cavity toward an opening to engage tissue located at or near the opening.

[0075] In Example 9, the subject matter of any one or more of Examples 1 to 8 may optionally include an arm rotatably connected to a distal tip and configured to rotate on at least a portion of the distal surface of the distal tip to engage tissue located at or near the opening.

[0076] In Example 10, the subject of any one or more of Examples 1 to 9 may optionally include an arm that is pivotally or rotatably connected to a distal tip and configured to extend distally from the distal end of the distal tip to engage tissue located at or near the opening.

[0077] Example 11 is an endoscope system comprising: an endoscope body defining a working channel extending along a longitudinal axis of the endoscope body, the working channel defining an opening at a distal tip of the endoscope body; an arm connected to the distal tip of the endoscope body and movable relative to the endoscope body and the working channel to engage and remove tissue from the opening of the working channel; and an actuator connected to the arm and operable to move the arm relative to the endoscope body and the working channel.

[0078] In Example 12, the subject of Example 11 may optionally include a lens handle connected to a proximal portion of the lens body, an actuator connected to the lens handle, and the actuator being operable by a user via the lens handle.

[0079] In Example 13, the subject matter of any or more of Examples 11 to 12 may optionally include a controller connected to the mirror body and configured to transmit signals to the actuator to operate the actuator.

[0080] In Example 14, the subject matter of Example 13 may optionally include a sensor configured to transmit a signal to a controller, the controller being configured to detect a blockage at the distal tip based on the signal, and the controller being configured to operate an actuator when a blockage is detected.

[0081] In Example 15, the subject matter of any one or more of Examples 11 to 14 may optionally include an actuator cavity extending along the longitudinal axis of the scope and separate from the working channel, wherein an arm, actuator wire or shaft is at least partially located within the actuator cavity and movable from the actuator cavity to an opening to engage tissue located at or near the opening.

[0082] Example 16 is an endoscope system comprising: an endoscope body defining a working channel extending along a longitudinal axis of the endoscope body and defining an irrigation channel extending along the longitudinal axis, the working channel defining an opening at a distal tip of the endoscope body; a fluid pump in fluid communication with the irrigation channel, operable to generate a fluid flow through the irrigation channel; and a valve connected to the irrigation channel and the working channel, operable to divert the fluid flow from the irrigation channel to the working channel to engage tissue located at or near the opening.

[0083] In Example 17, the subject matter of Example 16 may optionally include a vacuum pump in fluid communication with the working channel, the vacuum pump being operable to generate a vacuum flow through the working channel.

[0084] In Example 18, the subject of Example 17 optionally includes a controller connected to a fluid pump, a vacuum pump, and a valve, the controller being configured to control the operation of the fluid pump, the vacuum pump, and the valve.

[0085] In Example 19, the subject matter of Example 18 may optionally include a sensor configured to transmit a signal to a controller, the controller being configured to detect a blockage at the distal tip based on the signal, and the controller being configured to operate a valve when a blockage is detected to divert fluid flow from the flushing channel to the working channel to engage tissue located at or near the opening.

[0086] In Example 20, the subject of Example 19 may optionally include a controller configured to disable the vacuum pump before operating the valve to redirect fluid flow from the flushing channel to the working channel.

[0087] In Example 21, the apparatus or method described in any one or any combination of Examples 1 to 20 may be optionally configured such that all of the described elements or options are available or selected from.

[0088] The detailed description above includes reference to the accompanying drawings, which form a part of the detailed description. The drawings illustrate, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as “examples.” Such examples may include elements other than those shown or described. However, the inventors also contemplate examples in which only those elements shown or described are provided. Furthermore, the inventors contemplate examples (or one or more aspects thereof) using any combination or arrangement of those elements shown or described relative to a particular example (or one or more aspects thereof) or relative to other examples shown or described herein (or one or more aspects thereof).

[0089] In the event of any inconsistency between the usage in this document and any other document incorporated by reference, the usage in this document shall prevail. In this document, the terms “including” and “in which” are used as concise English equivalents to the corresponding terms “comprising” and “wherein”. Furthermore, in the appended claims, the terms “including” and “comprising” are open-ended, meaning that a system, apparatus, article, composition, formulation, or treatment that includes elements other than those listed after such terms in the claims is still considered to fall within the scope of the claims.

[0090] In this document, as is common in patent documents, the terms “a” or “an” are used to include one or more, regardless of any other instance or use of “at least one” or “one or more.” In this document, unless otherwise indicated, the term “or” is used to refer to a non-exclusive “or,” such that “A or B” includes “A but not B,” “B but not A,” and “A and B.” In this document, the terms “including” and “in which” are used as concise English equivalents to the corresponding terms “comprising” and “wherein.” Furthermore, in the appended claims, the terms “including” and “comprising” are open-ended, meaning that a system, apparatus, article, composition, formulation, or treatment that includes elements other than those listed after such terms in the claims is still considered to fall within the scope of the claims. Additionally, in the appended claims, the terms “first,” “second,” and “third,” etc., are used merely as labels and are not intended to impose numerical requirements on their objects.

[0091] The above description is intended to be illustrative and not restrictive. For example, the examples above (or one or more aspects thereof) may be used in combination with each other. For example, other embodiments may be used by those skilled in the art after consulting the above description. An abstract is provided to enable the reader to quickly determine the nature of the technical disclosure. It is understood that this abstract is not intended to interpret or limit the scope or meaning of the claims. Furthermore, in the detailed embodiments above, various features may be combined to simplify the disclosure. This should not be construed as meaning that any unclaimed disclosed feature is necessary for any claim. Rather, the subject matter of the invention may lie in fewer than all features of a particular disclosed embodiment. Therefore, the appended claims are incorporated herein by way of example or embodiment, wherein each claim exists independently as a separate embodiment, and it is contemplated that such embodiments may be combined with each other in various combinations or arrangements. The scope of the invention should be determined by reference to the appended claims and the full scope of their equivalents.

Claims

1. An endoscope system, comprising: A mirror body defining a working channel extending along the longitudinal axis of the mirror body, the working channel defining an opening at the distal tip of the mirror body; as well as An arm, which is connected to the distal tip of the endoscope and is movable relative to the endoscope and the working channel, to engage and remove tissue from the opening of the working channel.

2. The endoscopic system according to claim 1, comprising: An actuator, which is connected to the arm and operable to move the arm relative to the mirror body and the working channel.

3. The endoscopic system according to claim 2, comprising: A lens handle is attached to the proximal portion of the lens body, an actuator is attached to the lens handle, and the actuator can be operated by the user via the lens handle.

4. The endoscope system according to any one of claims 2, comprising: A controller, which is connected to the mirror body and configured to transmit signals to the actuator to operate the actuator.

5. The endoscopic system according to claim 4, comprising: A sensor is configured to transmit a signal to the controller, the controller being configured to detect a blockage at the distal tip based on the signal, and the controller being configured to operate the actuator when a blockage is detected.

6. The endoscopic system according to any one of claims 2 to 5, further comprising: A line or shaft, at least partially extending through the mirror body, to connect the actuator to the arm.

7. The endoscope system according to claim 6, wherein, The mirror body includes an actuator cavity that extends along the longitudinal axis of the mirror body and is separated from the working channel. The arm, the line, or the shaft is at least partially located within the actuator cavity and is movable along the actuator cavity.

8. The endoscope system according to claim 6, wherein, The endoscope includes an actuator cavity extending along the longitudinal axis of the endoscope and separated from the working channel. The arm, the line, or the shaft is at least partially located within the actuator cavity and is movable from the actuator cavity toward the opening to engage tissue located at or near the opening.

9. The endoscope system according to any one of claims 1 to 8, wherein, The arm is rotatably connected to the distal tip and is configured to rotate on at least a portion of the distal face of the distal tip to engage tissue located at or near the opening.

10. The endoscopic system according to any one of claims 1 to 9, wherein, The arm is pivotally or rotatably connected to the distal tip and is configured to extend distally from the distal end of the distal tip to engage tissue located at or near the opening.

11. An endoscope system, comprising: A mirror body defining a working channel extending along the longitudinal axis of the mirror body, the working channel defining an opening at the distal tip of the mirror body; An arm, which is connected to the distal tip of the endoscope and is movable relative to the endoscope and the working channel, to engage and remove tissue from the opening of the working channel; as well as An actuator, which is connected to the arm and operable to move the arm relative to the mirror body and the working channel.

12. The endoscopic system of claim 11, comprising: A lens handle is attached to the proximal portion of the lens body, an actuator is attached to the lens handle, and the actuator can be operated by the user via the lens handle.

13. The endoscopic system of claim 11, comprising: A controller, which is connected to the mirror body and configured to transmit signals to the actuator to operate the actuator.

14. The endoscopic system of claim 13, comprising: A sensor is configured to transmit a signal to the controller, the controller being configured to detect a blockage at the distal tip based on the signal, and the controller being configured to operate the actuator when a blockage is detected.

15. The endoscopic system according to any one of claims 11 to 14, wherein, The endoscope includes an actuator cavity extending along the longitudinal axis of the endoscope and separated from the working channel. An arm, wire, or shaft of the actuator is at least partially located within the actuator cavity and is movable from the actuator cavity toward the opening to engage tissue located at or near the opening.

16. An endoscope system comprising: A scope body defining a working channel extending along a longitudinal axis of the scope body and a rinsing channel extending along the longitudinal axis, the working channel defining an opening at the distal tip of the scope body; A fluid pump, which is in fluid communication with the flushing channel, is operable to generate a fluid flow through the flushing channel; as well as A valve, connected to the flushing channel and the working channel, is operable to divert fluid flow from the flushing channel to the working channel to engage tissue located at or near the opening.

17. The endoscopic system of claim 16, comprising: A vacuum pump, which is in fluid communication with the working channel, is operable to generate a vacuum flow through the working channel.

18. The endoscopic system of claim 17, comprising: A controller connected to the fluid pump, the vacuum pump, and the valve, the controller being configured to control the operation of the fluid pump, the vacuum pump, and the valve.

19. The endoscopic system of claim 18, comprising: A sensor is configured to transmit a signal to the controller, which is configured to detect blockage of the distal tip based on the signal, and the controller is configured to operate the valve when blockage is detected to divert fluid flow from the flushing channel to the working channel to engage tissue located at or near the opening.

20. The endoscopic system according to claim 19, wherein, The controller is configured to: The vacuum pump is disabled before the valve is operated to redirect the fluid flow from the flushing channel to the working channel.

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